Laser Refractive Surgery

Laser Refractive surgery is used to improve the refractive state of the eye and decrease and in some cases even eliminate any dependency on glasses, contact lenses or other visual aids. This type of eye surgery uses numerous methods of surgical remodelling of the cornea using a process called keratomileusis, as well as lens implantation and lens replacement. Today the most common refractive surgery procedures utilise excimer lasers to reshape the curvature of the cornea. 

 

Laser Refractive eye surgery can reduce and in some cases cure a number of common vision disorders such as:

 

  • Myopia

  • Hyperopia

  • Presbyopia

  • Astigmatism.

 

Common Refractive Surgery Techniques

 

Automated Lamellar Keratoplasty:

Also known as ALK, this surgical procedure has the eye surgeon using a microkeratome to cut a thin flap of the corneal tissue to create a flap which is very much like a hinged door. This is used to access and remove targeted tissue from the corneal stroma before putting the flap back in place. 

 

Laser-assisted in Situ Keratomileusis (LASIK): 

An ophthalmologist who is trained in this surgical technique uses a microkeratome or a femtosecond laser to cut a flap of the corneal tissue. This flap is also used in a similar manner as in the ALK technique to access the targeted tissue in the corneal stroma, but this tissue is then removed using an excimer laser. Please note that when the flap creation procedure is done using an IntraLase femtosecond laser the surgical method is referred to as IntraLASIK.

 

Femtosecond Lenticule Extraction: 

Also known as ReLEx or simply FLEx is a surgical process in which a femtosecond laser is used to cut a lenticule within the corneal stroma. A LASIK-like flap is then surgically created to access the lenticule. This is then removed through a process of manual dissection using a blunt spatula and forceps.

 

Small Incision Lenticule Extraction: 

Also known as ReLEx or SMILE, is a surgical procedure in which a lenticule within the corneal stroma is cut using a laser. This same surgical laser is then used to cut a small incision along the periphery of the lenticlue and the eye surgeon then removes the lenticule leaving the anterior lamellae of the cornea intact.

 

Laser-Assisted Sub-Epithelium Keratomileusis:

Also known as LASEK,  is a surface surgical procedure which uses an excimer laser to ablate targeted corneal stroma tissue to change the shape of the cornea. An alcohol solution is used to loosen a thin layer of the epithelium which is then lifted using a trephine blade. Please note that

EPI-LASIK is a refractive surgical technique which is similar to LASEK which uses epi-keratome instead of a trephine blade and alcohol to remove the top layer of the epithelium.

 

Customized Transepithelial No-touch:

Also known as C-TEN, this is a corneal surgery process which avoids any corneal manipulation and instead uses a complete laser-assisted trans-epithelial approach. C-TEN is done on an individual eye morphology basis and can treat a large variety of corneal pathologies.

 

Radial Keratotomy:

Also known as RK, this is an older eye surgery procedure which uses spoke-shaped incisions to alter the shape of the cornea and reduce myopia or astigmatism.

 

Arcuate Keratotomy:

Also known as AK or astigmatic keratotomy, this is a refractive surgery technique which uses curvilinear incisions at the periphery of the cornea to correct high levels of non-pathological astigmatism.

 

Limbal Relaxing Incisions:

Also known as LRI, this is a surgical procedure which uses incisions near the outer edge of the iris to correct minor astigmatism. This refractive surgery technique is normally performed in conjunction with an Intraocular Lens implantation.

 

References 

 

Eye Surgery South Africa

Wikipedia

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